Hemorrhoids are swollen, inflamed veins in the rectum that can ache and bleed. They are very common and are usually caused by
constipation
, a low-fiber diet, a sedentary lifestyle,
pregnancy
,
or
liver cirrhosis
.

The most important interventions for hemorrhoids aim at reversing their causes. Adopting a high-fiber diet, sitting down less, getting plenty of exercise, and maintaining regular bowel habits can make a significant difference.

Medical treatment consists mainly of stool softeners and moist heat. In more severe cases, surgical procedures may be used.

Contrary to popular belief, it does not appear that consumption of foods spiced with hot chili peppers causes any discomfort or harm to people with hemorrhoids; a double-blind study found no difference in symptoms following consumption of hot peppers or placebo.
11

Principal Proposed Natural Treatments

Bioflavonoids are colorful substances that occur widely in the plant kingdom. Reasonably good, though not indisputable, evidence suggests that the
citrus bioflavonoids
diosmin and hesperidin (in a special micronized combination preparation) may be helpful for hemorrhoids.
12

For example, a 2-month,
double-blind, placebo-controlled
trial of 120 individuals with recurrent hemorrhoid flare-ups found that treatment with combined
diosmin
and
hesperidin
significantly reduced the frequency and severity of hemorrhoid attacks.
1
Another double-blind, placebo-controlled trial of 100 individuals had positive results with the same bioflavonoids in relieving symptoms once a flare-up of hemorrhoid pain had begun.
2
A 90-day, double-blind trial of 100 individuals with bleeding hemorrhoids also found significant benefits for both treatment of acute attacks and prevention of new ones.
3
Finally, this bioflavonoid combination was found to compare favorably with surgical treatment of hemorrhoids.
4
However, less impressive results were seen in a double-blind, placebo-controlled study, in which all participants were given a fiber laxative with either combined diosmin and hesperidin or placebo.
5

Other sources of bioflavonoids have been studied, as well. For example, in a 4-week, double-blind, placebo-controlled trial of 40 people with hemorrhoids, use of an extract made from the bioflavonoid-rich herb
bilberry
significantly reduced hemorrhoid symptoms as compared to placebo.
10
In addition, according to some but not all double-blind studies, the semi-synthetic bioflavonoids known as
oxerutins
may also be helpful for hemorrhoids, including the hemorrhoids that occur during pregnancy.
6,7

Although it is not known precisely how flavonoids work, it is thought that they stabilize the walls of blood vessels, making them less susceptible to injury.

Traditional herbal remedies for hemorrhoids include
calendula
(applied topically), Collinsonia root (oral or topical),
oak bark
(topical),
slippery elm
(oral or topical), and
witch hazel
(topical). However, there has been little to no scientific evaluation of these treatments.

For a discussion of homeopathic approaches to hemorrhoids, see the article of that name in the
Homeopathy
database.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Al-Waili NS, Saloom KS, Al-Waili TN, et al. The safety and efficacy of a mixture of honey, olive oil, and beeswax for the management of hemorrhoids and anal fissure: a pilot study.
Sci World J
. 2006;6:1998-2005.